Penn Medicine has been selected as one of seven adult field trial sites to test proposed diagnostic criteria for the American Psychiatric Association’s (APA) fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Used by health professionals around the world, DSM is the manual that provides descriptions, symptoms and other criteria for diagnosing mental disorders. Penn Medicine is participating in field trials to help assess the practical use of proposed DSM-5 criteria in real-world clinical settings.

“We are honored to be selected as one of the field trial sites,” said Dr. Mahendra T. Bhati, assistant professor of clinical psychiatry, who will lead the field trials at Penn Medicine. According to the APA, the selection process was very competitive; only 11 organizations were chosen from the 65 that submitted proposals to be considered for a field trial site.

Clinicians participating in the field trials will evaluate new and existing patients at different stages of treatment using the proposed DSM-5 diagnostic criteria and measures. Penn Medicine clinicians will focus particularly on proposed updates related to general anxiety disorder, OCD and hoarding, anxious depression, and binge eating disorders, along with general diagnostic criteria for personality disorders.

The field trial design will address several important aspects of the proposed diagnostic criteria, including:

• Feasibility: are the proposed criteria easy for clinicians to understand and to use?

• Clinical Utility: do the proposed criteria do a good job in describing patients’ psychiatric problems and help clinicians make decisions about treatment plans?

• Reliability: are the same conclusions reached consistently when the criteria are used by different clinicians?

• Validity: how accurately do the diagnostic criteria reflect the mental disorders they are designed to describe?

In addition, the field trials will test new tools that help clinicians evaluate the severity of symptoms and measure whether patients are improving over time, such as “cross-cutting dimensional assessments,” to measure symptoms that occur across a wide range of diagnoses (i.e. sleep problems).

“Psychiatrists at Penn Medicine demonstrate the highest level of expertise in mental health research and clinical care,” said Dr. David Kupfer, chair of the DSM-5 Task Force. “This field trial research is a part of a critical phase in development of DSM-5 and will give us the information we need to better understand how the proposed revisions affect clinicians’ practices and, most importantly, patient care.”

The field trials follow a public comment period in which more than 8,000 written comments on the draft diagnostic criteria were submitted to the DSM-5 website by clinicians, researchers and family and patient advocates. Submitted comments were reviewed by DSM-5 Work Groups and resulted in further refinement of the criteria. The field trial results will help improve the criteria and provide invaluable information for DSM-5, to be released in May 2013.